At the heart of social entrepreneurship is a simple question: what problems are worth solving, even when the traditional marketplace does not see enough profit in them? Dr. David Fajgenbaum’s answer came from his own hospital bed. 

As a young medical student, former Georgetown football player, and cancer researcher, Fajgenbaum developed Castleman disease, a rare immune system disorder that nearly killed him. His organs failed, his body filled with fluid, and doctors eventually told him there were no more treatment options.

Fajgenbaum did not accept that answer. He studied his own blood samples, reviewed medical research, and searched for existing drugs that might work. Eventually, he identified sirolimus, a generic drug usually used for kidney transplant patients. The drug has kept his Castleman disease in remission for more than a decade. That experience became the foundation for Every Cure, a nonprofit that uses artificial intelligence (AI) to find new uses for existing medicines.

Building a Social Enterprise

A social enterprise uses business tools to address a social problem. It needs funding, strategy, operations, partnerships, and measurable results like many traditional businesses. But unlike a traditional business, its main purpose is creating social value rather than maximizing profit. 

Every Cure fits that model because it is trying to fix a market failure. Drug companies often have little financial incentive to test old, generic drugs for new uses, especially when the diseases affect small patient populations. Rare diseases may affect only a few thousand people, or even a few dozen. Developing a brand-new drug can cost billions of dollars and take more than a decade, so pharmaceutical companies may focus on treatments with larger markets. Every Cure is not driven by profit, but by the search for solutions.

Using AI to Search for Hidden Matches

Drug repurposing is not new. Medicines such as minoxidil, Viagra, and semaglutide became known for uses different from their original purposes. What is new is the speed and scale that AI can bring to the search. Every Cure compares roughly 4,000 drugs with more than 18,000 diseases, creating about 75 million possible drug-disease matches. Its AI platform scores possible matches, and medical researchers then review the most promising leads. 

While doctors can prescribe drugs off-label for conditions they were not originally approved to treat, this approach carries risks, including uncertain effectiveness and the potential for harmful side effects. FDA approval is not always required for these uses, but it can increase confidence among doctors and patients and make insurance coverage more likely. For that reason, physician oversight and careful clinical judgment remain essential when deciding whether to try these unconventional treatments.

For this reason, among others, the organization does not stop after finding a possible match. The discovery has to reach doctors, gain insurance coverage, and actually make it into patients' hands. To this end, Every Cure works on lab research, clinical trials, regulatory discussions, doctor education, and patient access. 

Funding a Mission-First Model

Every Cure’s model also shows a major challenge for social entrepreneurs: funding a mission can be hard. Many donors want to fund research for a specific disease that has affected their family. Every Cure chose not to work that way. It is “disease agnostic,” meaning it searches across all drugs and diseases for the best opportunities to help people. Fajgenbaum said the organization has turned down money when donors wanted it used only for one disease, because that could pull the nonprofit away from its broader mission.

Eventually, Every Cure attracted major support, including funding commitments from TED’s Audacious Project and ARPA-H, a federal health research agency. Those funds help the nonprofit pursue clinical trials and build the infrastructure needed to move treatments toward patients.

Measuring Success 

The impact is already visible. In one case, Joseph Coates, a Washington man with POEMS syndrome, was near death when Fajgenbaum’s team suggested an unconventional drug combination identified with help from AI. Coates responded within a week, became healthy enough for a stem cell transplant, and is now in remission.

Every Cure is also working on Bachmann-Bupp syndrome, an ultra-rare neurodevelopmental disorder. A decades-old drug originally developed for African sleeping sickness appears to help block a protein involved in the disease. Several children treated with the drug have shown meaningful improvements.

These stories show why social entrepreneurship matters. Markets are powerful, but they do not solve every problem on their own. When profit incentives aren’t strong enough for traditional businesses, social entrepreneurs can build new systems that focus on people who might otherwise be overlooked.

In the Classroom

This article can be used to discuss social entrepreneurs (Chapter 5: Small Business and Entrepreneurship).

Discussion Questions

  1. Why do pharmaceutical companies often have weak incentives to develop treatments for rare diseases?

  2. Why do you think Every Cure chooses a disease-agnostic approach? 

  3. Describe how Every Cure illustrates the concept of social entrepreneurship.

 

This article was developed with the support of Kelsey Reddick for and under the direction of O.C. Ferrell, Linda Ferrell, and Geoff Hirt.